After kidney donation by a healthy individual, the remaining kidney by the donor increases in kidney cell size, compensating for a functional capacity of approximately 60-80% of kidney function of two kidneys. The mechanism that drives this still remains elusive. This project will use novel genetic tools to identify key components that lead to healthy kidney growth.

Clinical:

People on kidney dialysis often suffer from symptoms of severe and overwhelming pain, tiredness, nausea, cramping, itching, trouble sleeping, depression and anxiety, which contributes to a poor quality of life. The Symptom monitoring With Feedback Trial (SWIFT) pilot will test how easy it is to measure symptoms and quality of life every 3-6 months through the use of a table that will feed this information back to the patients' dialysis nurse and kidney doctor. SWIFT aims to improve quality of life and survival by focussing on symptom management and encouraging communication between doctors and their patients.

Dr Louise PurtellQueensland University of Technology “The REPOSE Study (Randomised Evaluation of the Provision of a Sleep Intervention in End-stage Kidney Disease)”

Many people with chronic kidney disease (CKD) experience sleep problems like difficulty falling asleep, difficulty staying asleep and drowsiness during the day. This can lead to poor quality of life and can also worsen other health problems. Our team will test whether a personalised program including activities such as relaxation techniques and simple exercise may improve sleep quality. An individual sleep plan will be developed for each patient.

Psychosocial:

Chronic kidney disease (CKD) is a serious health problem. On top of physical effects, CKD patients often experience depression and anxiety which then affects their ability to follow treatment, their quality of life, social interaction and general wellbeing. The Kidney Optimal Health Program (KOHP) provides one-on-one individual support about stress and vulnerability and its impact on health and well-being.

We have developed a way of helping dialysis patients through the use of tablet and phone app. The aim of this research is to help people on dialysis understand the choices they have about their health, and help them be more involved with those decisions. To support our multi-cultural community we have translated the app into Arabic and Mandarin initially. The intention is for dialysis patients to use the app to make changes that will improve their health and quality of life, and reduce their need for unscheduled or emergency health care visits.

Funding Research Initatives for Better Kidney Health Tomorrow

As a major funder of kidney research outside the National Health and Medical Research Council, we have underpinned the evidence base that drives strategy and policy development for the advancement of public health, with specific regard to kidney health.

Support of kidney research is crucial for:

the long-term improvement of health outcomes for those with, or at risk of, kidney disease

the development of state and federal government kidney-related health policy

building Australia’s evidence base to drive and underpin an accessible and equitable healthcare service.

In funding our research program, we receive support from institutions, organisations and, importantly, individual benefactors.

A notable example is the bequest that enabled the establishment of the Bootle Award Medical Research Grant.

AusDiab Study

AusDiab is the largest Australian longitudinal population-based study examining the natural history of diabetes, pre-diabetes, heart disease and kidney disease. The study, which is run by the Baker Heart and Diabetes Institute, was awarded the 2006 Victorian Department of Human Services Public Health Research Award for Excellence. KHA considered this work to be of enormous importance to Australian’s affected by kidney disease and as such provided significant seed funding to enable the inclusion of a ‘kidney component’ in the AusDiab study.

The baseline study conducted in 1999–2000 provided benchmark national data on the prevalence (or number of people) with diabetes, obesity, hypertension and kidney disease in Australia. The second phase of AusDiab, completed in December 2005, was a five year follow-up of the people who participated in the baseline survey. A twelve year follow-up was completed in 2012, with the results released in August 2013.

The results of these studies provide a unique picture of the incidence (or number of new cases) of diabetes, cardiovascular disease and kidney disease over 12 years, and allows us to improve our understanding of the factors that increase the risk of these conditions. The results have been presented at key National and International meetings, and have been used by health services and Governments in planning provision of health services, providing Consensus Statements and in considering screening for CKD.

KHA provided seed funding of $20,000 to enable the inclusion of a “kidney component” in the AusDiab study, comprising the addition of urine testing (ACR, PCR and dipstick analysis) to the planned measurements of biochemical status (which included serum creatinine and diabetic status) plus measurement of blood pressure, behaviours relevant to health and an assessment of quality of life using the SF-36 instrument. A second round of strategic funding from KHA of $300,000 over 2003-5, matched by funds provided by the Royal Prince Alfred Hospital, enabled the ongoing AusDiab Kidney study which continues to this day.

The following is selected publications resulting from the AusDiab Kidney Study. The research was primarily designed and supervised by Professor Steve Chadban, A/Professor Kevan Polkinghorn and Professor Bob Atkins, however the work has been performed by many talented researchers.

In addition to key AusDiab-Kidney papers, this list includes papers which arose through collaborative efforts whereby AusDiab contributed to pooled data, most importantly and strategically through the CKD-Prognosis Consortium, or served to provide an Australian adult control population for comparative studies with indigenous Australians and with kidney transplant recipients as examples. Both avenues will continue to provide important papers, with ongoing collaborative work in train through the CKD-Prognosis Consortium and with ANZDATA. The list below does not include several manuscripts in preparation, which currently include important papers on changes in Quality of Life over time in CKD and another on progression of CKD in a community cohort.